Trimming meal support for elders will cost us more, not less
Jacqueline Vance, RNC, CDONA/LTC
A 2015 controlled trial by Brown University Center for Gerontology funded by AARP found that home-delivered meals, and specifically the meals on wheels program, provide health and psychological benefits to seniors beyond basic nutrition.
The study was structured as a three-arm, randomized, controlled trial to determine what effect home-delivered meals may have for older adults. The idea was to look beyond just providing essential nutrition.
What the research found was that there were statistically significant differences in health benefits among the three groups studied, with the greatest benefits shown for those participants living alone who had face-to-face contact with the daily delivery of the “meals on wheels” personnel.
The study's participants were made up of hundreds of seniors who were on the waiting list to receive home-delivered meals in eight sites around the country. In this study they either received personally delivered fresh meals daily, or weekly bulk deliveries of frozen meals, or they simply remained on the waiting list. Participants in each group answered questions about their physical and mental health at the beginning of the study and again after the end of the 15-week study period.
OK, so I am not going to drop over from surprise at the results. Elders living alone who received the daily meal delivery showed statistically significant reductions in feelings of isolation than those who received meal delivery on a weekly basis. They also felt significantly less lonely, less scared/worried about staying in their homes. And they said they felt safer.
Think about this: This meal delivery may be the only face-to-face interaction this elder has on a given day. Sending bulk frozen food, while it might provide nutrition for those who are physically and mentally able to work a microwave (and many on the program can't — that's why they are on the program) still doesn't give them the face-to-face interaction needed for the other proven benefits.
Has anyone ever read David Bloustein Blue Zone books? One thing in common is in every “Blue Zone” (a place where people aged healthy, both physically and mentally) there was a tight community. People check on people and socialize every day!
What I also found cool in this research is that it discovered that those getting daily meal deliveries had fewer falls and hospitalizations than those receiving weekly meal drops or those in the third group (those kept on the waiting list). But, wait, there's more: Brown University also found that a hot daily meal delivery program reduced nursing home occupation.
For every $25 spent on the program, the low-care nursing home population in that state dropped a percentage point. Really! I mean, decreased falls, decreased hospitalization and reduced nursing home stays … wouldn't that save tons of Medicare dollars? (I ask sarcastically).
And here is a little bit of factual data for those who say the program is not cost effective: Meals on Wheels America, one such national meal delivery program, says the organization can provide meals for senior citizens for one year for roughly the same cost as just a one-day stay in a hospital.
According to the Henry J. Kaiser Family Foundation, a nonprofit, private operating foundation based in Menlo Park, CA, the annual meal cost is $2,765 for 250 days, compared to the cost of one day in the hospital: around $2,271.
A Portland, OR-based service, “Meals on Wheels People,” which is also one of the largest in the country, says it costs $2,500 annually to provide daily meals to a homebound senior. Meanwhile, the cost of institutional care for a year in Oregon is around $60,000. Hmmm, lets do the math!
But wait a minute, weren't we just told that programs like Meals on Wheels are being dropped or subsidized less because the White House says that there is no benefit from the programs and that they basically are not cost effective?
I mean, why feed this very vulnerable population anyway? Anybody ever see Soylent Green? Let them feed us right? (Gross! But I am scared that something like that will be stuck in the next bill that goes before Congress. You know, especially since old people cost too much to take care of ...)
Federal financing for the Older Americans Act continues to drop while the number of older adults continues to rise (at about 10,000 a day). Now it seems as if funding for Meal on Wheels will be reduced. Oh, and it also appears that we might be getting rid of some child nutrition programs for our poor and disadvantaged children, so don't expect their brains to develop properly and take care of you when you are old, either.
I've always talked about growing old gracefully. I never thought about being scared to grow old. Until now.
Just keeping it real,
The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, an APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet. The opinions supplied here are her own and do not necessarily reflect those of her employer or her professional affiliates.